| Preoperative carriage and postoperative same-species sternal wound infection after cardiac surgery. | |
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MedLine Citation:
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PMID: 21788302 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Sternal wound infection (SWI) after cardiac surgery remains an important problem. Prediction of pathogens involved in such infection could guide antibiotics. From April 1, 2006 to December 31, 2008, retrospectively, we evaluated the diagnostic value of preoperative methicillinsensible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA) or multi-drug resistant Gram-negative bacillus (MDRGNB) carriage to predict same-pathogens involved in postoperative SWI. All patients referred for elective cardiac surgery were screened using multisite (nares, axillae, rectal) sampling at admission to detect MSSA, MRSA, and MDRGNB. Of the 1895 patients addressed, 425 patients (22.4%) were colonized at admission. Preoperative carriers more frequently developed SWI than non-carriers, respectively, 11% vs. 5.5% (P<0.05). Because of the small sample, MDRGNB carriers could not be analyzed. For prediction of MSSA SWI with preoperative MSSA carriage, the area under the receiver operating characteristic (ROC) curve was 0.720 (95% confidence interval (CI), 0.364-0.796) and 0.710 (95% CI, 0.623-0.787) for prediction of MRSA SWI with preoperative MRSA carriage. Preoperative MSSA carriage is frequent but preoperative MRSA or MDRGNB carriage remains infrequent. The ability of preoperative carriage to predict a same-pathogen-postoperative SWI was low and should not be used to guide empirical antibiotherapy. Keywords: Sternal wound infection; Preoperative carriage; Methicillin-sensible Staphylococcus aureus; Methicillin resistant Staphylococcus aureus; Multi-drug Gram-negative bacillus; Cardiac surgery. |
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Authors:
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Jean-Michel Maillet; Gregoire Oghina; Paul Le Besnerais; Stephane Thierry; Genevieve Bouquet; Patrick Mesnildrey; Nicolas Bonnet; Denis Brodaty |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-25 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: - ISSN: 1569-9285 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Cardio Vascular and Thoracic Intensive Care, Centre Cardiologique du Nord, Saint-Denis, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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